A child received the MMR vaccine when he was 9 months of age before moving out of the country with his parents. He is now 4 years old and about to enter Kindergarten. How many, if any, doses of MMR should the child receive now?

The recommendation for the MMR (measles, mumps, rubella) vaccine is that children typically receive two doses. The first dose is administered between 12 and 15 months of age, and the second dose is given between 4 and 6 years of age.

In this scenario, the child received his first MMR dose at 9 months, which is earlier than the recommended age. While an early dose may provide some level of protection against these diseases, it does not fulfill the established immunization schedule. Therefore, to ensure the child is fully vaccinated according to guidelines, he will need to receive the second dose at 4 years old, as the completion of the two-dose series is crucial for effective immunity.

Given that the child is now 4 years old and about to enter Kindergarten, he should receive one additional dose of the MMR vaccine to meet the primary vaccination requirements.